The characteristics of patients with possible familial hypercholesterolemia-screening a large payer/provider healthcare delivery system.
Adult
Cholesterol, LDL
/ blood
Cohort Studies
Comorbidity
Cross-Sectional Studies
Databases, Factual
Delivery of Health Care
/ organization & administration
Electronic Health Records
Female
Humans
Hyperlipoproteinemia Type II
/ diagnosis
Israel
/ epidemiology
Male
Middle Aged
Risk Factors
Social Class
Young Adult
Journal
QJM : monthly journal of the Association of Physicians
ISSN: 1460-2393
Titre abrégé: QJM
Pays: England
ID NLM: 9438285
Informations de publication
Date de publication:
01 Jun 2020
01 Jun 2020
Historique:
received:
12
10
2019
revised:
24
11
2019
pubmed:
29
12
2019
medline:
16
3
2021
entrez:
29
12
2019
Statut:
ppublish
Résumé
Familial hypercholesterolemia (FH) is an under-diagnosed condition. We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Familial hypercholesterolemia (FH) is an under-diagnosed condition.
AIM
OBJECTIVE
We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH.
METHODS
METHODS
A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population.
RESULTS
RESULTS
The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated.
CONCLUSIONS
CONCLUSIONS
By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.
Identifiants
pubmed: 31883017
pii: 5688752
doi: 10.1093/qjmed/hcz327
doi:
Substances chimiques
Cholesterol, LDL
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
411-417Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.